A: Most pseudocysts that are less than 4-6 centimeters resolve spontaneously, although this can take some time.

Q: What feature makes them unlikely to spontaneously resolve?
show answer

A: Large cysts and those in persistent communication with the pancreatic duct are less likely to spontaneously resolve.

This patient went on to have a partial pancreatectomy.

Pathology

Specimen consists of the distal pancreas measuring 11 x 6 x 5 cm. A cross-section of the pancreas shows two separate intact cysts measuring 6 cm and 2.4 cm in greatest dimension that are filled with a pus-like material and necrotic debris.

Case Discussion

Pancreatic pseudocyts can be a challenge to manage and up to half of all pseudocysts do not resolve spontaneously. Additionally, when small and in cases where a firm history of pancreatitis is not present, they can pose a diagnostic challenge, and mimic cystic neoplasms.